Letter from the Editor

Thanks to everyone who asked for more information on the “sartan” contamination recall. Some of you asked how this happened, a few wanted to know the science behind it, and almost everybody wanted to know how the pharmaceutical industry and the FDA were going to fix it.

With those comments in mind, we have put together a feature to answer your questions and links if you want to dig even deeper. Check out Item #2: The ARB Recall: What Really Happened.

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Did You Know: Testing for Prediabetes Much Earlier Has Major Benefits

In a new study, it has been shown that monitoring blood glucose in midlife can help prevent future cardiovascular disease. Diagnosing prediabetes and discussing treatment options can greatly benefit the patient, as it is much easier to treat prediabetes and possibly prevent or delay getting diabetes. Not only can you help to prevent cardiovascular disease, but you can reduce the cost dramatically in future treatments and in preventing possible complications. In a recent study published in Diabetes Care, the researchers used data from 7 observational studies from 1960 to 2015 that included 19,630 individuals without a prior cardiovascular event. Absolute risk of cardiovascular disease was determined through analysis of participants’ fasting glucose category beginning at age 55 through age 85. The study found that the risk for cardiovascular disease ranged from 15.3% (<5.0 mmol/L) to 38.6% (diabetes levels) among women and from 21.5% (5.0 to 5.5 mmol/L) to 47.7% (diabetes levels) among men. Increases in glucose to the diabetes level during midlife were associated with substantially higher cardiovascular risk than when glucose levels stayed below the diabetes threshold. The study provides further evidence that if you can diagnosis diabetes earlier or prediabetes and avoid diabetes, you may be able to stave off cardiovascular disease. Prediabetes should serve as a red flag to doctors to closely monitor their patient’s glucose to try to help prevent or delay diabetes through lifestyle interventions, like better diet and increased physical activity, and, if necessary, with pharmacologic therapies. Although in this study they used a fasting glucose to diagnose prediabetes, using the A1c test to diagnosis prediabetes is a better predictor of prediabetes and diabetes. As most health care providers prescribe a complete blood panel for a physical, the patient is asked to fast, so they can get a fasting triglyceride result. By fasting prior to checking for prediabetes, the patient’s glucose results will be on the lower side and miss the diagnosis of prediabetes and diabetes 25% of the time. That is why doing an A1c test will provide a better picture for diagnosing prediabetes. So, when you have a patient who has an A1c of 5.5% close to the diagnosis of prediabetes, which is an A1c of 5.7%, it is worth having a discussion of lifestyle changes with the patient not only for the prevention or delay of diabetes, but also for the prevention of cardiovascular disease, including reducing their medical costs over their lifetime. — https://doi.org/10.2337/dc18-1773

Thanks to everyone who asked for more information on the “sartan” contamination recall. Some of you asked how this happened, a few wanted to know the science behind it, and almost everybody wanted to know how the pharmaceutical industry and the FDA were going to fix it.

With those comments in mind, we have put together a feature to answer your questions and links if you want to dig even deeper. Check out Item #2: The ARB Recall: What Really Happened.

In a new study, it has been shown that monitoring blood glucose in midlife can help prevent future cardiovascular disease. Diagnosing prediabetes and discussing treatment options can greatly benefit the patient, as it is much easier to treat prediabetes and possibly prevent or delay getting diabetes. Not only can you help to prevent cardiovascular disease, but you can reduce the cost dramatically in future treatments and in preventing possible complications. In a recent study published in Diabetes Care, the researchers used data from 7 observational studies from 1960 to 2015 that included 19,630 individuals without a prior cardiovascular event. Absolute risk of cardiovascular disease was determined through analysis of participants’ fasting glucose category beginning at age 55 through age 85. The study found that the risk for cardiovascular disease ranged from 15.3% (<5.0 mmol/L) to 38.6% (diabetes levels) among women and from 21.5% (5.0 to 5.5 mmol/L) to 47.7% (diabetes levels) among men. Increases in glucose to the diabetes level during midlife were associated with substantially higher cardiovascular risk than when glucose levels stayed below the diabetes threshold. The study provides further evidence that if you can diagnosis diabetes earlier or prediabetes and avoid diabetes, you may be able to stave off cardiovascular disease. Prediabetes should serve as a red flag to doctors to closely monitor their patient’s glucose to try to help prevent or delay diabetes through lifestyle interventions, like better diet and increased physical activity, and, if necessary, with pharmacologic therapies. Although in this study they used a fasting glucose to diagnose prediabetes, using the A1c test to diagnosis prediabetes is a better predictor of prediabetes and diabetes. As most health care providers prescribe a complete blood panel for a physical, the patient is asked to fast, so they can get a fasting triglyceride result. By fasting prior to checking for prediabetes, the patient’s glucose results will be on the lower side and miss the diagnosis of prediabetes and diabetes 25% of the time. That is why doing an A1c test will provide a better picture for diagnosing prediabetes. So, when you have a patient who has an A1c of 5.5% close to the diagnosis of prediabetes, which is an A1c of 5.7%, it is worth having a discussion of lifestyle changes with the patient not only for the prevention or delay of diabetes, but also for the prevention of cardiovascular disease, including reducing their medical costs over their lifetime. — https://doi.org/10.2337/dc18-1773